While individuals can improve their own work, it takes a group to improve a process.
And let’s face it: it’s hard to get a group of diverse people to mesh well enough to per-form smoothly the many sequential tasks of the quality improvement process. A team might have incredible knowledge and creativity but still flounder because team members don’t work well together. To be successful, a quality improvement team must master not
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only the quality improvement process and quality tools but also the challenges of group effectiveness.
The broad topics of group dynamics and team management are beyond the scope of this book. However, here are some basic facilitation tools, including team roles, that help any group function more effectively and efficiently.
Facilitator
Quality improvement teams are most effective and efficient when they have a facilita-tor. This role may be filled by the team leader or by another individual, from either within the work group or a resource group. The more critical or highly visible the pro-ject, the more important it is that the team be guided by someone specially trained and experienced in facilitation skills.
Regardless who acts as facilitator, his or her most important function is focusing on meeting and project process, not content. Content means ideas and suggestions, prob-lems and solutions, data and analysis. Process means how work is done: keeping meet-ings on track, enabling contributions from all team members, dealing with group problems, following the quality improvement process, and using appropriate quality tools correctly. The first three process topics are well covered in books on group dynamics and team management. The latter two aspects of process directly relate to the subject of this book. Of course, the team leader (if that is a separate role) and team mem-bers also can and should help with these tasks. But until a team has experience, memmem-bers rely on the facilitator to guide them through the quality improvement process, to sug-gest tools, and to lead the group through the tools’ procedures.
It’s worth repeating: having a facilitator who is focused on process is the most valu-able tool for getting more out of meetings and making the project move forward rapidly.
Planning and Agenda
The project leader and facilitator (if these are two separate roles) should plan the meet-ing together, with input from team members. These questions can help with the plannmeet-ing:
• What is the purpose of the meeting?*
• At what step are we in our quality improvement process?*
• What results are desired from the meeting?*
• Who should be there—or need not be there?*
• What pre-meeting work should be completed? What information should be brought to the meeting?*
• What methods and tools will be used?*
• What alternate methods and tools could be used if this plan doesn’t work?
• Which of these tools is the group familiar with? Which will need to be taught?
• What materials are needed?
• What is the best sequence of activities?*
• How long should each topic take?*
• What issues or problems might arise? How will they be handled?
Items marked with an asterisk should be included on an agenda sent to meeting atten-dees in advance. This allows everyone to come to the meeting prepared to contribute.
Flipchart
Nothing has yet taken the place of the basic flipchart for capturing and displaying a group’s ideas. Once ideas are captured on flipchart pages, the group can see them, reflect on them, build on them, and make progress. Flipchart pages can be posted around the meeting room as a constant display, unlike transparencies. Flipcharts also generate a record that can be taken from the meeting room and transcribed, unlike most white-boards. (Some whiteboards do print a copy, but it is too small to display for the group.) Following are some tips on using flipcharts:
• Use markers that don’t bleed through the paper.
• Have a variety of different colored markers. Black, blue, purple, and green can be seen best, but red is good for adding emphasis. Avoid yellow and orange—
they become invisible at a distance. Use different colors to add meaning.
• Whenever you use flipcharts, have tape with you—strong enough to hold the pages but gentle enough not to peel paint. (Or substitute tacks if meeting room walls have tack strips or pinboard.) As a page is completed, tear it off and post it on a wall where everyone can see it. Don’t just flip the page over (despite the name of this tool) or the ideas will be unavailable to the group.
• See the brainstorming considerations (page 131) for other suggestions about capturing ideas on flipcharts.
Whiteboard
• Whiteboards are useful for creating large diagrams, such as a fishbone or tree diagram. The kind that can make copies are even more useful for such tasks.
• Whiteboards are also useful for tasks that don’t need to be preserved, such as tallying paired comparisons.
• Use a whiteboard instead of a flipchart if it’s big enough for all the anticipated ideas and a permanent record isn’t necessary (are you sure?) or if you
absolutely have no choice—but then be prepared for someone to spend time after the meeting transcribing the information.
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• Plan the size and layout of your writing carefully so that you won’t run out of room on the whiteboard before the group runs out of ideas.
Parking Lot
Title a flipchart page with those words and post it on the wall before the meeting. When an idea arises that is off-subject, write it on the parking lot without discussing it. As the meeting proceeds, if a parking lot item becomes relevant, bring it into the discussion and cross it off the parking lot. At the end of the meeting, review the items left in the parking lot. Assign action items, if appropriate; retain items for future meetings (put the idea in the meeting record); or drop the item if the group agrees.
Scribe
In fast-paced or large meetings, have someone other than the facilitator capture ideas on the flipchart or whiteboard. This frees the facilitator to call upon contributors, manage discussion, help summarize complicated ideas, monitor time, and otherwise run the meeting.
• Rotate the scribe job. Otherwise the person acting as scribe never gets to participate as fully as the others.
• In a really hectic meeting, such as a fast and furious brainstorming session, two simultaneous scribes may be necessary, writing alternate contributions.
• Scribing can help involve someone who seems remote from the discussion.
• The scribe can contribute ideas to the discussion too. However, if you are scribing, you should never just write your idea. Instead, switch to a participant role for a moment, get recognition from the facilitator, stop scribing, and state your idea to the group. Then go back to scribing by writing your idea.
Other Roles
• A timekeeper keeps track of how much time has been spent on a topic and how much time is left. The group agrees in advance how much time is appropriate;
having a timekeeper then frees the rest of the group (including the facilitator) to focus on the subject, methods, or tools instead of thinking about time.
• Use a timekeeper to meet the group’s needs. A timekeeper may be necessary only during one exercise. Or if time has been a problem for the group, the timekeeper may be needed throughout the meeting.
• A note taker keeps track of major discussion points, decisions made, action items, assignments, deadlines, and items set aside for future work. The note taker later prepares the meeting record.
• The note taker is not the scribe. The scribe writes ideas on the flipchart or whiteboard for all to see. The note taker takes notes for the record.
• Roles are often combined. For example, the facilitator may act as timekeeper and/or note taker. However, knowing they are separate functions can help your team share responsibilities.
Action List
An ongoing list of action items keeps track of what the team agreed should be done, who agreed to do it, when it should be completed, and status. This list should be reviewed at the end of every meeting. Meeting records should include the updated action list. See Medrad’s corrective action tracker (page 63) for an example.
Meeting Record
After the meeting, the note taker combines his or her notes plus key information from flipchart work into a meeting record sent to participants, managers, sponsors, and any other stakeholders who need to stay informed of the project’s progress.
Meeting Evaluation
Evaluating the meeting and the team’s progress gets everyone thinking about process.
See meeting evaluation in Chapter 5 (page 345) for more information.